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An Unwelcome Embrace

An Unwelcome Embrace Editorial Adverse Pulmonary–Aortic Interactions in Pulmonary Hypertension Michael A. Quail, MBChB, PhD; Vivek Muthurangu, MD ascular remodeling in pulmonary hypertension (PH) compliance. This is the characteristic impedance (Z ) of the Vcauses increased ventricular afterload, resulting in vessel, and Z governs ventricular load in early systole. The Z c c right ventricular failure and high mortality. Afterload is the is directly related to pulse wave velocity (c) as follows: mechanical impedance imposed by the arterial tree, against which the ventricle must work to eject blood. Despite the Z =ρcA /, (1) cd tendency to conflate afterload with blood pressure, it cannot where A is vessel diastolic area, and ρ is blood density. As be reduced to a single number or variable. Instead it is more 2,3 can be seen from Equation 1, ventricular load in early sys- appropriately defined in terms of pressure-flow relations. tole is increased in vessels with smaller areas and elevated See Article by Schäfer et al 10 9 pulse wave velocity. Therefore, Schäfer et al results imply Afterload is divided into several steady and pulsatile com- increased aortic Z in pediatric PH patients and increased LV ponents, including vascular resistance, total arterial compli- afterload. However, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Circulation: Cardiovascular Imaging Wolters Kluwer Health

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References (13)

Publisher
Wolters Kluwer Health
Copyright
© 2017 American Heart Association, Inc.
ISSN
1941-9651
eISSN
1942-0080
DOI
10.1161/CIRCIMAGING.117.006063
pmid
28193614
Publisher site
See Article on Publisher Site

Abstract

Editorial Adverse Pulmonary–Aortic Interactions in Pulmonary Hypertension Michael A. Quail, MBChB, PhD; Vivek Muthurangu, MD ascular remodeling in pulmonary hypertension (PH) compliance. This is the characteristic impedance (Z ) of the Vcauses increased ventricular afterload, resulting in vessel, and Z governs ventricular load in early systole. The Z c c right ventricular failure and high mortality. Afterload is the is directly related to pulse wave velocity (c) as follows: mechanical impedance imposed by the arterial tree, against which the ventricle must work to eject blood. Despite the Z =ρcA /, (1) cd tendency to conflate afterload with blood pressure, it cannot where A is vessel diastolic area, and ρ is blood density. As be reduced to a single number or variable. Instead it is more 2,3 can be seen from Equation 1, ventricular load in early sys- appropriately defined in terms of pressure-flow relations. tole is increased in vessels with smaller areas and elevated See Article by Schäfer et al 10 9 pulse wave velocity. Therefore, Schäfer et al results imply Afterload is divided into several steady and pulsatile com- increased aortic Z in pediatric PH patients and increased LV ponents, including vascular resistance, total arterial compli- afterload. However,

Journal

Circulation: Cardiovascular ImagingWolters Kluwer Health

Published: Feb 1, 2017

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